目的：探讨新生儿耳聋基因与听力联合筛查的意义。方法对2014年6～12月出生的546例新生儿，采集足跟血进行基因测序，对常见的4个耳聋基因的20个位点进行筛查；包括 GJB2（35delG、167delT、176＿191de116、235delC、299＿300delAT），GJB3（538C→ T、547G→A），SLC26A4（281C→ T、589G→ A、IVS7－2A→ G、1174A→T、1226G→ A、1229C → T、IVS15＋5G → A、1975G → C、2027T → A、2162C → T、2168A → G ），线粒体DNA12S rRNA（1494C→T、1555A→G），同时利用 TEOAE和AABR进行联合听力筛查。结果546例中，22例（4．03％，22／546）有耳聋基因突变，包括：GJB2基因突变14例，占2．56％（14／546）；SLC26A4基因突变7例，占1．28％（7／546）；线粒体DNA12SrRNA基因突变1例，占0．18％（1／546）。听力初筛未通过25例（4．58％，25／546），25例均进行复筛，复筛未通过12例，确诊9例听力损失，其中双耳极重度听力损失1例，双耳重度听力损失2例，双耳中度听力损失2例，左耳中度听力损失4例，这9例中8例耳聋基因筛查异常。结论单纯进行听力筛查或者单纯进行耳聋基因筛查可能会漏掉部分耳聋患儿，新生儿耳聋基因联合听力筛查，有利于耳聋儿童的早期发现与早期干预。

临床上,儿童环杓关节脱位相对少见,常由电子内镜检查、全身麻醉下气管插管或由颈部外伤所致.由于儿童管腔较小,使用较大型号的气管会增加术后咽痛及声嘶的发生率[1],如治疗不及时可能导致永久性声嘶[2].我科于2009-04-2014-07期间收治9例环杓关节脱位患儿,均在直接喉镜下采取环杓关节复位术,效果满意,现报告如下.

OBJECTIVE:To study the effectiveness of tympanoplasty for treatment of chronic otitis media and cholesteatoma in children.METHOD:Twenty-three cases with chronic otitis media and cholesteatoma treated by tympanoplasty were retrospectively studied, among which 15 cases had complete clinical data. The condition of surgical cavities, the duration of getting dry ears, the hearing improvements, the growth of new ear drums and whether the recurrence of cholesteatomas occurred or not were observed.RESULTS:In all patients, the chief complains were ear discharging and hearing loss. The tympanum membranes(pars flaccid or pars tensa) became retracted or perforated and CT scan showed mastoid processes were poor developed in some cases with lesions mainly located at attic, middle tympanum cavity and/or petrous parts. The duration of getting dry ear was (6.0 +/- 1.5) weeks after surgery. The effective rate was 80%. The hearing of 12 cases has been improved, that of 2 cases has no changed, that of 1 case has been descended, and 1 case exhibited recurrent cholesteatoma after surgery.CONCLUSION:This study demonstrated that children's chronic otitis media and cholesteatoma have their own clinic features of wide erosiveness and strong aggressiveness, and tympanoplasty has been proved to treat this disease effectively, also been proved to improve these patients' hearing cognitions and eventually improve their life qualities.

总结了12例在鼻内镜下应用低温等离子技术治疗小儿扁桃体腺样体术后出血的观察结果与护理体会,12例患儿均一次性止血成功。主要护理措施有心理护理、观察口腔分泌物、防止窒息和饮食护理等。认为通过观察低温等离子治疗小儿扁桃体腺样体术后出血的情况,证明该技术具有创伤小、安全、恢复快、成功率高的显著特点,且无明显后遗症,是目前治疗术后出血的理想选择。

Objective To explore effective nursing intervention through clinical analysis of middle ear function of children with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods Tympanogram was obtained from both pre-operation and post-operation in 413 OSAHS cases(the OSAHS group).Audiogram was conducted if the tympanogram was abnormal.There were 279 cases of normal children in the control group.The incidence of middle ear function loss of two groups were compared.Results 288 cases(328 ears) had some degree of middle ear dysfunction,accounting for 69.73％.69 cases had some degree of hearing loss,accounting for 16.71％.The incidences of middle ear dysfunction and degree of hearing loss in the OSAHS group were higher than 7.53％ and 1.43％ of the control group.The hearing ability was gained after operation in both groups.Conclusions The incidence of middle ear dysfunction is higher in children with obstructive sleep apnea hypopnea syndrome.But the bad influence alleviated with age.Therefore,early detection,timely treatment and effective nursing can achieve good effect.

<正>纤维塑性支气管炎是指内生性异物局部或广泛性堵塞支气管,导致肺部部分或全部通气功能障碍的一种疾病,因其内生性堵塞物堵塞支气管,取出时呈支气管塑性而得名。目前普遍认为纤维塑性支气管炎与某些支气管肺疾病,如支气管哮喘、囊性肺纤维化、变态反应性支气管肺曲霉菌病有关[1]。本病

<正>儿童上气道手术,如扁桃体、腺样体、鼻息肉等手术后,因本能的护疼,造成不正常的发声,使声带长期处于紧张的非正常生理状态,且影响儿童正常的语言发育,严重地影响了儿童的生存质量。此类疾病中常以单纯性及肥厚性喉炎、声带小结、声带

Objective To investigate behavioral problems in children with obstructive sleep apnea hypopnea syndrome(OSAHS),so as to provide scientific basis for psychological health education and ensure children's physical and mental health.Methods A total of 28 children aged from 6 to 12 years were selected from the department as the OSAHS group and another 28 healthy children were chosen as the control group.Results The scores of OSAHS children in social withdrawal,body complain,aggression and hyperactivity were significantly higher than the healthy group(P0.01 or P0.05).Conclusion Compared with the healthy children,the OSAHS children have certain behavior problems.It's essential to give psychological and behavioral intervention to the children with OSAHS.

<正>披裂黏膜脱垂症极为少见,病因系杓状软骨黏膜及黏膜下组织松弛,在吸气时向声门脱垂,引起患儿吸气性喘鸣或吸气困难。早期诊断和及时治疗披裂黏膜脱垂尤为重要[1]。我科2010年10月收治1例该症患儿,经手术治疗及术后对症护理,痊愈出院。现就披裂黏膜脱垂症的临床特点及护理体会总结报告如下。

Objective To investigate the temperament of children who have suffered from foreign body airway obstruction and their parents' parenting styles so as to provide a theoretical basis for disease prevention.Methods A total of 240 cases of hospitalized children who suffered from foreign body airway obstruction from Feb.2006 to Jun.2007 was regarded as patient group,and choosing 240 cases of age and sex-matched was the normal group.Then to investigate their temperament and parents' parenting style.Results The scores of activity level,rhythmicity,phobotaxis,adaptation,reaction intensity,mood,persistence and distractibility were statistically significant different between the two groups(P0.01 or P0.05).And there were different parenting styles between the two groups on the dimension of emotional warm,punishment and refusal(P0.01).Conclusion The main temperaments of children who have suffered from airway foreign body obstruction are difficult characteristic type and lean-difficult characteristic type.And their parenting styles on the dimension of emotional warm,punishment and refusal are different from other children.It is necessary to design appropriate interventions based on the temperaments and parenting styles.

Objective To study the parenting characristics of parents of children with foreign body in respiratory tract, and to provide information for clinical practice. Methods A total of 240 children with foreign body in respiratory tract (denoted as the research group )and 240 healthy children(denoted as the normal group ) were recruited into the study. The parenting styles of parents in both groups were investigated by using the EMBU scale. Results Fathers′parenting characteristics in both groups had significant difference in emotional warmth and rejection(P<0.05,P<0.01). Mothers′parenting characteristics presented significant diffe-rence in emotional warmth, rejection and punishment(P<0.05,P<0.01). Conclusion Parents of children with foreign body in respiratory tract give their children more emotional warmth and less rejection and punishment than parents of healthy children. Nurses should take measures based on parenting styles of parents, give information about feeding and safety to parents, help children to change poor eating habits, and help to create good dining environment.

我科2002～2003年对支气管异物并肺炎的患儿在进行常规内科治疗的同时,应用支气管镜进行肺泡灌洗,然后注射抗生素,治疗肺部感染性疾病128例,疗效显著,既可迅速地清除局部大量脓性分泌物,又可有效地控制感染.现报告如下.

目的:评价可调式口腔矫治器治疗儿童阻塞性睡眠呼吸暂停综合征( OSAS)的疗效.方法: 45例 OSAS 患儿,采用多导睡眠仪监测戴用可调式口腔矫治器前后多项指标变化如:呼吸紊乱指数( AHI),呼吸暂停指数( AI),最低sao2和睡眠效率等指标并进行分析.结果:45例OSAS患儿AHI有效率(P＜0.01):10例轻度患儿为66.7% ,23例中度患儿为62.1%,12例重度患儿67.9%.AI有效率(P＜0.01):10例轻度患儿为61.5%,23例中度患儿有效率为69.6%,12例重度68.4%.最低sao2显著升高(P＜0.01):10例轻度患儿升高2.6% ,23例中度患儿升高8.5%,12例重度患儿16.5%.睡眠效率升高(P＜0.01):10例轻度患儿升高19.4 % ,23例中度患儿升高19.9%,12例重度患儿45.6%.患者睡眠质量均有显著改善,鼾声消失或明显减轻.结论:可调式口腔矫治器治疗儿童阻塞性睡眠呼吸暂停综合征( OSAS)疗效明显.

[目的]探讨儿童先天性眼球震颤的手术方法及其护理。[方法]回顾分析43例采用手术治疗先天性水平性眼球震颤。[结果]手术后前方眼球基本不颤12例(27.91%),减轻29例(67.44%),无变化2例(4.65%);28例代偿头位者中消失11例(39.29%),减轻17例(60.71%);41例视力提高;11例外斜,5例矫正为正位,6例欠矫;2例外上斜无改善;1例内斜视欠矫。无任何并发症发生。[结论]儿童先天性眼球震颤,根据不同的眼震类型可选择不同的手术方式,钟摆型采用眼内直肌、眼外直肌后巩膜固定术,冲动型采用Anderson法矫正,并采取术前、术后护理,大多数病例可获得好的疗效。

Objective To explore humanistic modes of nursing care and improve the result of health education for children. Methods Reading materials were written according to the principles of bibliotherapy. A total of 136 children in perioperative period were asked to read the materials with their parents or on their own. Results The results showed that 94.85% of the children and 97.06% of their care-givers identified with the contents of the reading materials and their form of illustrated text. 64.71%-75.00% of the children and their care-givers learned some knowledge about the operations and 86.76% of children were willing to cooperate in the treatment and nursing care. Conclusion The contents and form of the reading materials for hospitalized children are in line with the development of cognitive ability of children and it can, to some degree, help the hospitalized children to adapt to the environment of hospital.

鼻腔异物多见于儿童,这是因为儿童幼稚、好奇心强,在玩耍时常将纸卷、棉球、小玻璃球、滚珠、塑料玩具、钮扣、小石块、豆类等异物塞入鼻腔,是小儿耳鼻喉科门诊常见的一种疾病,常因患儿不会说或不敢说有异物塞入鼻腔,多在出现鼻塞、流脓涕或鼻臭时才就诊而被发现.

目的 探讨1～3岁呼吸道异物患儿的气质特点,了解其心理特征,并进行护理干预.方法 呼吸道异物住院的1～3岁患儿190例,采用儿童气质软件(CPCTS)及气质测查问卷,由家长填写问卷配以计算机录入分析结果的形式进行评估.结果 D型患儿行为问题比E型多,以品行问题、焦虑、冲动多动、学习问题、多动指数等突出.S型、I-D型、I-E型患儿的行为问题也较E型多,但不如D型突出;S型患儿心身障碍较其他气质类型患儿突出.结论 中间偏易养型、易养型是0～3岁小儿的主要气质类型.应根据不同性别及年龄段小儿的特点给予针对性的教育和指导,促进小儿健康成长.

OBJECTIVE To explore the different character of children from 0 to 3 years old, understand their psychological features, give guidances about nurturing and educating children, and supply theoretical base for preventing problems of children behaviors. METHOD Two hundred and fifty-one children patients from 0 to 3 years old were surveyed from clinic of maternal and child health care with children character software and questionnaire. RESULT Among all characters, 32.3% children were easy and medium nurturing type, 31.1% easy nurturing type, 23.1% difficult nurturing type, 7.5% slow startup and 6.0% difficult and medium type. CONCLUSION Main character of children from 0-3 years old are easy and medium nurturing type and easy nurturing type. Children with different ages and sexes have different characters, so pertinent education and guidance should be given according to characters of different ages and sexes so as to improve their health.

分泌性中耳炎(SOM)为儿童多发病,并被认为是发展中国家儿童听力损失的最常见病因.这种发育期间的听力损失将导致儿童的语言、教育及心理上的发育障碍[1].其发病因素复杂,与细菌感染、免疫反应有关.我科于2002年4月～2003年10月收治分泌性中耳炎患儿59例,采用腺样体摘除术加鼓膜切开术,现报告如下.

CT仿真内窥镜成像(CTVE)作为一项新技术目前在欧、美地区已得到快速的开发和应用,特别是在大血管等方面不断取得新的进展[1-3].但CT仿真支气管镜作为其衍生技术在儿童支气管疾病的临床诊断方面的应用尚鲜见报道.我科于1999年2月～2004年2月应用该项技术对42例复杂支气管疾病患儿进行了CT仿真支气管镜检查,并与硬支气管镜术中所见进行分析、对比,探讨CT仿真支气管镜(CTBE)技术在小儿支气管疾病诊断中的应用价值.现报道如下.